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Table 2 The clinicopathological characteristics and management of the children with intussusception in India

From: Prospective surveillance for intussusception in Indian children aged under two years at nineteen tertiary care hospitals

Variable Category

 

North

(n = 136)

South

(n = 262)

East

(n = 190)

West

(n = 33)

Total

(n = 621)

P value

Symptoms, n (%)

Vomitinga

100 (73.5)

187 (71.4)

137 (72.1)

27 (81.8)

451 (72.6)

0.64

Bilious vomitingb

21 (15.4)

26 (9.9)

34 (17.9)

9 (27.3)

90 (14.5)

0.02

Abdominal pain

102 (75.0)

118 (45.0)

138 (72.6)

10 (30.3)

368 (59.3)

< 0.01

Excessive crying

49 (36.0)

172 (65.7)

109 (57.4)

17 (51.5)

347 (55.9)

< 0.01

Abdominal distension

34 (25.0)

29 (11.1)

69 (36.3)

3 (9.1)

135 (21.7)

< 0.01

Rectal bleeding

81 (59.6)

123 (47.0)

139 (73.2)

18 (54.6)

361 (58.1)

< 0.01

Diarrhoea

23 (16.9)

69 (26.3)

37 (19.5)

9 (27.3)

138 (22.2)

0.11

Constipation

18 (13.2)

43 (16.4)

12 (6.3)

3 (9.1)

76 (12.2)

0.01

Fever

34 (25.0)

64 (24.4)

31 (16.3)

13 (39.4)

142 (22.9)

0.02

Lethargy

2 (1.5)

16 (6.1)

16 (8.4)

2 (6.1)

36 (5.8)

0.07

Altered sensorium

1 (0.7)

0 (0.0)

0 (0.0)

0 (0.0)

1 (0.2)

–

Classical triadc

52 (38.2)

64 (24.4)

87 (45.8)

13 (39.4)

216 (34.8)

< 0.01

Signs, n (%)

Pallor

11 (8.1)

14 (5.3)

18 (9.5)

3 (9.1)

46 (7.4)

0.39

Dehydration

7 (5.2)

21 (8.0)

43 (22.6)

2 (6.1)

73 (11.8)

< 0.01

Fever

4 (2.9)

23 (8.8)

23 (12.1)

5 (15.2)

55 (8.9)

0.02

Lethargy

11 (8.1)

14 (5.3)

20 (10.5)

3 (9.1)

48 (7.7)

0.23

Abdominal distension

22 (16.2)

25 (9.5)

62 (32.6)

3 (9.1)

112 (18.0)

< 0.01

Abdominal tenderness

13 (9.6)

26 (9.9)

26 (13.7)

5 (15.2)

70 (11.3)

0.48

Abdominal mass

13 (9.6)

91 (34.7)

24 (12.6)

4 (12.1)

132 (21.3)

< 0.01

Bowel sound (absent/ abnormal)

11 (8.1)

10 (3.8)

43 (22.6)

2 (6.1)

66 (10.6)

< 0.01

Rectal prolapse

15 (11.0)

2 (0.8)

1 (0.5)

0 (0.0)

18 (2.9)

< 0.01

Rectal mass

3 (2.2)

4 (1.5)

11 (5.8)

0 (0.0)

18 (2.9)

0.04

Blood on PR examination

19 (14.0)

31 (11.8)

94 (49.5)

19 (57.6)

163 (26.3)

< 0.01

Modified triadd

83 (61.0)

125 (47.7)

143 (75.3)

21 (63.6)

372 (59.9)

< 0.01

Diagnosis method, n (%)

Ultrasound

121 (89.0)

262 (100)

179 (94.2)

30 (90.9)

592 (95.3)

< 0.01

CT scan

2 (1.5)

0 (0.0)

0 (0.0)

0 (0.0)

2 (0.3)

–

Barium enema

1 (0.7)

0 (0.0)

1 (0.5)

1 (3.0)

3 (0.5)

–

Surgery

12 (8.8)

0 (0.0)

10 (5.3)

2 (6.1)

24 (3.9)

< 0.01

Intussusception location, n (%)

Colo-colic

3 (2.2)

10 (3.8)

5 (2.6)

3 (9.1)

21 (3.4)

< 0.01

Ileo-colo-colic

8 (5.9)

7 (2.7)

4 (2.1)

2 (6.1)

21 (3.4)

< 0.01

Ileo-ileal

11 (8.1)

3 (1.2)

10 (5.3)

6 (18.2)

30 (4.8)

< 0.01

Ileo-ileo-colic

4 (2.9)

5 (1.9)

6 (3.2)

0 (0.0)

15 (2.4)

< 0.01

Ileocolic

109 (80.2)

234 (89.3)

163 (85.8)

20 (60.1)

526 (84.7)

< 0.01

Jejuno-jejunum

0 (0.0)

0 (0.0)

1 (0.9)

1 (3.0)

2 (0.3)

–

> 1 locatione

1 (0.7)

3 (1.2)

1(0.5)

1 (3.0)

6 (1.0)

–

Pathological lead point, n (%)

Lymph node

41 (30.1)

19 (7.2)

3 (1.6)

15 (45.4)

78 (12.6)

< 0.01

Appendix

0 (0.0)

0 (0.0)

2 (1.0)

1 (3.0)

3 (0.4)

–

Payer’s patch

1 (0.7)

1 (0.3)

1 (0.5)

0 (0.0)

3 (0.4)

–

Polyp

1 (0.7)

0 (0.0)

0 (0.0)

1 (3.0)

2 (0.3)

–

Othersf

2 (1.4)

0 (0.0)

3 (1.6)

0 (0.0)

5 (0.8)

–

Any lead point

45 (33.0)

20 (7.6)

9 (4.7)

17 (51.5)

91 (14.6)

< 0.01

Treatment modality, n (%)

Reduction

56 (41.2)

216 (82.4)

20 (10.5)

14 (42.4)

306 (49.3)

< 0.01

Surgery

68 (50.0)

30 (11.5)

135 (71.1)

12 (36.4)

245 (39.5)

< 0.01

Spontaneously resolvedg

12 (8.8)

16 (6.1)

34 (17.9)

7 (21.2)

69 (11.1)

< 0.01

Noneh

0 (0.0)

0 (0.0)

1 (0.5)

0 (0.0)

1 (0.2)

–

Surgery type, n (%)

No resectioni

41 (60.3)

25 (83.3)

106 (78.6)

9 (75)

181 (73.9)

< 0.01

With resectioni

27 (39.7)

5 (16.7)

29 (21.5)

3 (25.0)

64 (26.1)

< 0.01

Outcome, n (%)

Discharged

129 (94.9)

262 (100)

181 (95.3)

31 (93.9)

603 (97.1)

< 0.01

Referred

0 (0.0)

0 (0.0)

1 (0.5)

2 (6.1)

3 (0.5)

–

LAMAj

3 (2.2)

0 (0.0)

1 (0.5)

0 (0.0)

4 (0.6)

–

Died

4 (2.9)

0 (0.0)

7 (3.7)

0 (0.0)

11 (1.8)

–

Brighton Collaboration Criteria level, n (%)

Level 1

125 (91.9)

246 (93.9)

156 (82.1)

26 (78.8)

553 (89.1)

< 0.01

Level 2

5 (3.7)

15 (5.7)

24 (12.6)

3 (9.1)

47 (7.6)

< 0.01

Level 3

0 (0.0)

0 (0.0)

0 (0.0)

0 (0.0)

0 (0.0)

–

No level

6 (4.4)

1 (0.4)

10 (5.3)

4 (12.1)

21 (3.4)

< 0.01

Illness in last 4 weeks, n (%)

Diarrhoea

10 (7.4)

55 (21.0)

11 (5.8)

4 (12.1)

80 (12.9)

0.04

ARI

17 (12.5)

104 (39.7)

21 (11.1)

5 (15.2)

147 (23.7)

0.04

  1. Notes: PR Per-rectal, ARI Acute respiratory illnesses
  2. aIncludes all vomiting including bilious vomiting
  3. bIncludes only bilious vomiting
  4. cClassical triad includes abdominal pain, vomiting and blood in stool
  5. dModified triad includes abdominal pain, vomiting and rectal bleeding (detected either as blood in stool or blood on per-rectal examination)
  6. eThe location of intussusception at more than one site; such as Ileo-colic + Colo-colic, Ileo-colic + Ileo-colo-colic, Ileo-colic + Ileo-ileo-colic, Ileo-colic + Ileo-ileal
  7. fOthers include cyst, Meckel’s diverticulum, incisional hernia, intraluminal growth and malrotation
  8. gSpontaneously resolved: The patient was managed with IV fluids and nil orally, not required any additional intervention
  9. h None- No definite treatment could be provided, as the patient(s) was referred or died before any definite treatment
  10. i The denominators used for percentage estimation include patients undergone surgery only
  11. jLAMA: Left against medical advice
  12. The p values for some parameters could not be estimated due to no value in at least two groups